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成都中医药大学 附属医院,成都 610072
Received:25 May 2020,
Published Online:03 September 2020,
Published:05 February 2021
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吴梦竹,张梨,李廷林等.基于心与小肠相表里探析肠道菌群与糖尿病认知障碍的关联[J].中国实验方剂学杂志,2021,27(03):231-237.
WU Meng-zhu,ZHANG Li,LI Ting-lin,et al.Analysis on Relationship Between Intestinal Flora and Diabetes Cognitive Impairment Based on "Paired Relationship Between Heart and Small Intestine"[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(03):231-237.
吴梦竹,张梨,李廷林等.基于心与小肠相表里探析肠道菌群与糖尿病认知障碍的关联[J].中国实验方剂学杂志,2021,27(03):231-237. DOI: 10.13422/j.cnki.syfjx.20202226.
WU Meng-zhu,ZHANG Li,LI Ting-lin,et al.Analysis on Relationship Between Intestinal Flora and Diabetes Cognitive Impairment Based on "Paired Relationship Between Heart and Small Intestine"[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(03):231-237. DOI: 10.13422/j.cnki.syfjx.20202226.
基于中医学心与小肠相表里理论,心病可及小肠,小肠病亦可反作用于心,而心主神明是心的重要功能。若小肠分清泌浊功能受损,会有碍于心主司神志活动的发挥。现代医学发现肠道菌群与认知功能的联系紧密,这与中医学“心与小肠相表里”相吻合。糖尿病认知障碍(DCI)在中医学里属于消渴呆病范畴。中医学认为,脾胃失衡是消渴呆病的始动因子,脾虚痰浊闭阻是消渴呆病的病理物质产物,临床有健脾醒脑法指导该病。以往项目证实肠道菌群紊乱是中医学脾胃失衡的现代病理基础,提示恢复脾胃功能以调整肠道微生物稳态有助于消渴呆病的防治。近年来DCI发病率上升迅速,发病机制复杂未明,增加了治疗难度,故寻找新的靶标不容忽视。目前糖尿病与肠道菌群紊乱互为因果关系方面的研究取得不少成果。基于肠道菌群与糖尿病、认知障碍均有复杂联系,梳理三者之间的关系尤为关键。立足于既往的科研基础,逐层分析,发现肠道菌群既能影响大脑内神经递质的合成,又参与慢性炎症、胰岛素抵抗、血糖上升等糖尿病与认知障碍的共同发病环节,具有典型的靶标作用。梳理肠道菌群与DCI的关联,以期为治疗建立新的靶点和方向,并深挖中医药调控脾胃治疗消渴呆病的科学内涵。
Based on theory of "paired relationship between the heart and the small intestine" in traditional Chinese medicine(TCM), heart disease can affect the small intestine, and intestinal diseases can also affect the heart. The heart controls mental activities, so if the secretions function of small intestine is impaired, it will hinder the mind of the mind. Modern medicine has found that intestinal flora is closely related to cognitive function, which is consistent with the "paired relationship between heart and small intestine" in TCM. Diabetes cognitive impairment (DCI) is a category of "diabetes dementia" in TCM. According to TCM, the imbalance of spleen and stomach is the starting factor of diabetes dementia, and the phlegm turbidity of spleen deficiency is the pathological product of diabetes dementia. Previous projects have proved that intestinal flora disturbance is the modern pathological basis of spleen and stomach imbalance in TCM, suggesting that restoring spleen and stomach function to adjust intestinal microbial homeostasis is helpful for the prevention and treatment of diabetes dementia. At present, many achievements have been made in the study of the mutual causality between diabetes and intestinal flora disorder. In recent years, the incidence of DCI has increased rapidly, and the pathogenesis is complex and unclear, which increases the difficulty of treatment. Therefore, finding new targets should not be ignored. Given the complex connections among intestinal flora, diabetes and cognitive impairment, it is particularly important to tease out the relationship among the three. Based on previous scientific research, the author analyzed layer by layer and found that intestinal flora can not only affect the synthesis of neurotransmitters in the brain, but also participate in the common pathogenesis of diabetes and cognitive impairment such as chronic inflammation, insulin resistance and blood glucose rise, with a typical target effect. The pathogenic mechanism of intestinal flora in DCI was summarized in order to establish a new target and direction for the treatment, and to explore the scientific connotation of TCM in regulating spleen and stomach for treatment of diabetes dementia.
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